NPIMap

Organization Active NPI

University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1184471690
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UNIVERSITY PEDIATRICIANS
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-5437
NPI assigned
May 2, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY PEDIATRICIANSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Harrison
Title
Coo
Phone
(313) 745-5870

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary
Pediatric Hematology & Oncology Physician 2080P0207X NU

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

3901 Beaubien St Ste H
Detroit, MI 48201-2119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000125 MI Part B Supplier - Clinic/Group Practice 9638070568 Receives reassigned benefits from 370 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Troy, MI; Detroit, MI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
University Pediatrician4 organizations share this tax ID, including this one
Part of
University Pediatrician

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4201 Saint Antoine St
Ste 226
Detroit, MI 48201
Phone (313) 966-2064

41925W 12 Mile Rd
Novi, MI 48377
Phone (248) 305-6172

350 W Big Beaver Rd
Ste B
Troy, MI 48084
Phone (248) 377-8717

Practitioners & affiliated clinicians

Practitioners 356

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 356

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1184471690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST STE H",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PEDIATRICIANS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY PEDIATRICIANS",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "313-745-5870"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.